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Chronic subdural hematoma in the elderly: a case report

M Elie1, F Primeau, M G Cole

  • 1Department of Psychiatry, McGill University, Montreal, Quebec, Canada.

Journal of Geriatric Psychiatry and Neurology
|April 1, 1996
PubMed

Insights

A chronic subdural hematoma caused psychiatric symptoms like depression and paranoia in an elderly man. Surgical drainage improved symptoms, highlighting the need for neurological investigation in elderly psychiatric patients.

Area of Science:

  • Neurology
  • Geriatrics
  • Psychiatry

Background:

  • Elderly patients can present with atypical psychiatric symptoms.
  • Chronic subdural hematoma (CSDH) is a potential cause of neurological and psychiatric disturbances.

Observation:

  • An 82-year-old male presented with a 3-month history of depressive and paranoid symptoms.
  • Initial physical and cognitive evaluations were normal, but persistent weight loss prompted further investigation.

Findings:

  • Medical investigations revealed a large left frontoparietal chronic subdural hematoma.
  • Surgical drainage led to partial improvement in paranoid symptoms, though depression persisted and required pharmacologic management.

Implications:

  • CSDH should be considered in the differential diagnosis of new-onset psychiatric symptoms in the elderly.
  • Early neuroimaging is crucial for diagnosing CSDH in older adults with unexplained psychiatric changes.
  • Management requires a multidisciplinary approach, addressing both the neurological and psychiatric aspects.

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